Migraine

Nerve decompression surgery for migraine

If other medications or treatments aren’t giving you any relief, as a last resort, surgery can be an option to address your migraine issues. Nerve decompression surgery removes muscle tissue, bone or blood vessels that constrict the nerves (which can cause migraine symptoms), giving more room and relieving your symptoms. 

What causes migraine pain?

While the exact cause for migraine pain is unknown, researchers believe it’s how your brain and nervous system interact with each other. Increases or decreases in brain chemistry, such as serotonin levels, is one theory about how migraine pain starts. Genetics also seem to contribute to migraine development, as certain triggers are shared by parents and their children.

In general, the most common triggers or causes of migraine pain are:

• Stress
• Weather changes
• Second-hand cigarette smoke
• Dehydration
• Skipping meals

Certain foods are believed to be migraine triggers for some people, too, though there is no evidence to prove this.

How common is a migraine attack?

Migraine affects millions of people, regardless of their age, geographic location, fitness level or other factors. About one in seven adults worldwide experience migraine attacks, so you’re not alone. They are more commonly experienced by women than men (18% of women vs. 6% of men). While migraine symptoms can occur at any age, they impact people between the ages of 15 and 55 the most.

What are the stages and symptoms of a migraine attack?

Prodrome

The prodrome (initial) stage of a migraine attack is marked by subtle warning signs.

Prodrome symptoms include:

• Mood changes (e.g., irritability, depression)
• Food cravings
• Increased yawning
• Stiff neck
• Fatigue
• Increased thirst and urination
• Constipation or diarrhea

Aura

During the aura stage, you may experience temporary neurological symptoms like visual disturbances, sensory changes or some difficulty with speaking. These all typically precede the intense headache associated with your migraine.

Attack

The attack stage is characterized by a severe headache, often accompanied by nausea and sensitivity to light and sound. Lasting for a few hours to several days, this represents the peak intensity of your migraine episode.

Postdrome

Following the migraine attack, the postdrome phase involves a period of lingering symptoms like fatigue, difficulty concentrating and mild headache, as your body gradually recovers from the migraine episode.

What are the different types of migraine?

There are several different types of migraine, each with its own set of triggers and treatment strategies. At Ohio State, our team of headache experts is highly familiar with diagnosing and treating each migraine type.

The most common migraine types are:

• Migraine without aura – As the most common type of migraine, its symptoms can be severe, ranging from a throbbing headache in one side of the head, sensitivity to light and sound, nausea and vomiting. These can typically last up to 72 hours.
• Migraine with aura – This is preceded by visual or sensory disturbances before the headache arrives. Symptoms can include seeing flashes of light, blind spots, tingling in the hands or face, or speech difficulties. These last up to an hour before the migraine itself.

• Chronic migraine – This is defined as having 15 or more migraine days per month, for multiple months.
• Migraine with brainstem aura (formerly known as “basilar-type migraine”) – This type affects the brainstem, which causes severe, disorienting neurological symptoms. Among the symptoms are vertigo, speech difficulties, loss of balance and ringing in the ears.
• Hemiplegic migraine – This migraine can cause temporary paralysis or sensory changes on one side of the body, such as weakness, numbness or tingling. Vision changes and difficulty with speaking are also common.
• Retinal migraine – This migraine affects vision in only one eye, with symptoms including temporary blindness, followed by a headache.
• Abdominal migraine – This migraine has symptoms that include abdominal pain, nausea and vomiting. It’s unique because it does not present itself as a headache.
• Vestibular migraine – Disorientation and vertigo are the hallmarks of this migraine, which has symptoms like dizziness, balance problems and sensitivity to motion. It can last for minutes or hours.

Are migraine related to concussions?

Both migraine and concussions cause similar symptoms. These can include headaches, dizziness, nausea, sensitivity to light and sound, and cognitive difficulties like trouble concentrating or memory problems.

Both conditions involve disruptions in brain function. Migraine are thought to involve abnormal brain activity affecting nerve pathways and brain chemicals, while concussions cause direct physical disruption to brain cells and structures from trauma.

In migraine, changes in brain blood flow and inflammation are part of the headache process. Following a concussion, inflammation and altered blood flow can also contribute to ongoing symptoms, including migraine symptoms.

A concussion can lead to the following conditions:

• Post-traumatic headache – Following a concussion, post-traumatic headaches are common. These headaches often have migraine-like features such as throbbing pain, sensitivity to light and sound, and nausea.
• Triggering migraine – A concussion can trigger the onset of migraine in individuals who have never had them. They can also make the severity and frequency of migraine much worse in those who’ve had them before.
• Chronic post-concussion syndrome: Some people can develop chronic post-concussion syndrome (PCS) after head injuries. These symptoms can persist for weeks or months at a time. Chronic headaches may resemble migraine symptoms and are a common part of PCS.